JOURNAL OF ARDABIL UNIVERSITY OF MEDICAL SCIENCES (JAUMS)
Year:2007 | Volume:7 | Issue:1 (23)|Papers Count:17

Background and Objectives: Staphylococcus aureus as a Gram- positive coccus causes a variety of infections in humans. It is one of the infectious agents in hemodialysis patients. Those patients who carry this organism at their nose are exposed to infection and possible morbidity and mortality due to this bacterium. Resistance to antibiotics in staphylococci is increasing. Resistance development is due to mutation and by plasmid DNA transmission. The aim of this study was to detenl1ine plasmid profile and antibiotic resistance of Staphylococcus aureus strains isolated from nasal carriers in dialysis patients in Imam Khomeini Medical Center. Susceptibility testing to antibiotics plasmid extraction and analysis and epidemiologic relationship of these isolates were investigated.Method: In this study nasal specimens of 107 patients in dialysis ward of Imam Khomeini Medical Center were collected and cultured on blood agar plates. The colonies were identified as Saurcus strains. The susceptibility of 50 strains isolated from the patients against 12 antibiotics were tested using Kirby- Bauer standard method. A standard Saureus strain (ATCC29213) was used to control quality of antibiotic discs. The isolates were cultured on LB medium and plasmid DNAs were extracted and electrophoresed on agarose gel using Parisi et al method.Results: The results of resistance rate against 12 used antibiotics were as follows: resistance of the strains against gentamicin, oxacillin, neomycin, clindamycin, erythromycin, cotrimoxazole. choloramphenicole, tetracycline, and ciprofloxacin were 20%, 28%, 30%, 26%. 30%. 44%. 32%, 36%, and 10% respectively. All of the strains were resistant to amoxycillin and pcnicillin and none of them were resistant to vancomycin. Of 50 S.aureus strains. only 27 strains contained plasmid DNA. Most of the strains revealed a big plasmid. Plasmid profiles of the strains will be presented.Conclusion: Our results showed that there was a close relationship between high resistance to antibiotics and presence of plasmids in S aureus strains. Similarities among resistance to antibiotics and plasmid profiles in our strains Isolated from the same ward showed that these strains were from the same sources and indicated a unique clonal possibility. The resistance to antibiotics of the strains lacking plasmids could be from chromosomal resistance.

Background and Objectives: Developmental dislocation of hip (DDH) as an inherited joint disorder results from external location of the head of femora from the acetabulum, early diagnosis of this disorder is very important and any delay may result in long life handicap.Nowadays new methods such as sonogrphy are recommended in diagnosis of this disorder. Radiology and physical examination are traditional methods. This study was designed to evaluate the results of sonographical, radiological and physical examination findings in 100 infants who were suspected to have DDH.Methods: This analytical-cross sectional study was done in private clinics from June 2004 to June 2005. The one hundred infants who were suspected to have DDH in physical examination entered the study. A questionnaire was completed for each infant, and then sonography and radioghray have been done for them. The data were collected and analyzed by statistical programs.Results: Among 100 infants 48% were female and 52% male, with mean age 42±7.23.In 44% they were the firstborn. 58% had normal delivery and 42% cesarean section. 15% had breech presentation. In 28% radiological and 56% sonographical methods showed findings in favor of DDH.Conclusion: This study showed, simultaneous physical and sonographic examination especially during the first month result in early and precise diagnosis of DDH, on the other hand it does not have radiologic side effects.

Background and Objectives: Hypertension is one of the major factors of cardiovascular diseases among hemodialysis patients which shoes its effect along with vascular changes. 75- 80% of the patients with ESRD are hypertensive. Despite much available drag to decrease the blood pressure, many of these patients remain hypertensive. The major cause Of Hypeliension is the increase in the blood volume which is due to the water and salt retention in the body. It doesn't seem that the uptake of body's fluid for a short period can have a remarkable effect on the pressure.Methods: This descriptive analytic study was done on 80 hemodialysis patients who were under treatment at Buali hospital. First patients were investigated according to age, sex, frequency of dialysis in the week and dialysis duration. These for each patient the blood pressure before and during dialysis and weight changes before and after dialysis with two consectille sessions were measured. Calculated and MAP was determined. Finally data was analyzed through SPSS. Results: 48 out of 74 patients (64.9%) had hypertension. Blood pressure was controlled in 41 patients (55.4%). Age, sex, dialysis period and sessions of dialysis did not have a significant relationship with hypertension control. The study showed a high prevalence of high blood pressure in hem6dialysis patients (64.9%). The blood pressure was not controlled in the majority of patients (44.6%).Conclusion: Patients' weight changes have no significant effect on hypertension. This shows that the causes for blood pressure can be due to other causes different from increase in the blood volume among hemodialysis patients and perhaps the chronic blood volume increase is not related to hypertension.

Background and Objectives: Visceral leishmaniasis is a reticulo endothelia system and it is known as 'black fever by Indians. According to WHO every year there are 500 thousand new cases of it in the world. The province of Ardabil, with 25-40% from all the country's leishmaniasis has a major part in the country and is considered as one of the main focuses in Iran. Due to its importance, this study was done to identify clinical signs and demographic characteristics of the patients.Methods: This was a descriptive cross-sectional study which was done retrospectively 110 children who were hospitalized in three different active hospitals between 1375-1382 entered in this study. Disease definition includes parasite detection in bone marrow aspivation or special clinical signs (fever, spleenomegal, pansytopenia and weight loss) in addition direct agglutination test was positive. The samples were investigated in terms of demographic information. Place of living, clinical signs and the length of time between the symptoms of the disease and its diagnosis. To get to the results, simple descriptive statistics was used. 37.8% of the patients were diagnosed from the beginning of symptoms with in a month. Results: There were 56.4% boys and 43.6% girls of all the 110 children. DAT test was done in 97 patients which was positive in 91 cases (minimum positive titer 1/400). In 42 patients biopsy and bone marrow aspiration was done which was positive in 26 cases (Lishmanbody detection). The age of the patients was 4 months -14 years. The most common findings were fever 97.3% and anorexia 97.1%. There was anemia in 90% thrombocytopenia in 60.8% and leukopenia in 24.8%. There was death in 6 patients (5.5%) and unresponsiveness to the treatment in 3 cases (2.7%).Conclusion: The results of the present study nearly correspond to those of other studies. The main vulnerable communities of visceral lieshmaniasis are mainly children. In order to decrease the mortality and morbidity its early diagnosis is essential. It is necessary that the physicians working in endemic regions be familiar enough with the disease.

Background and Objectives: Arthrosclerosis is the major cause of cerberovascular disorders and major problems of industrial countries. Mortality from chronic diseases such as arthrosclerosis and mortality from infectious diseases have a reverse, relationship with economic and educational levels of people. For this reason, investigating the relationship of MI with other risk factors such as infections has been of great interest.Methods: This was a case- control study 60 patients with MI and 60 matched cases were selected from other wards of Boali Hospital. All of the patients who had been admitted with myocardial infarction diagnosis in the time of study were selected and information about them was recorded in a researcher made questionnaire. Serum sample from patients and control case were sent to determinations of IgG Anti Chlamydia antibodies with enzyme immune assay. Control case was selected from other wards of hospital who matched in age, sex and same test in serum sample was done.Results: In this study in each group 48 persons (80%) were male and 12 persons (20%) were female. The range of age group was 35-80. Mean age group was 58.83±12.6(SD) and mean age of control tools was 59.08±11.59. All of the patients in each group had anti Chlamydia antibodies (IgG) (titer more than 5U/ml). The mean range IgG in both groups were compared through t-test and there was no significant difference between them (p=0.85).Conclusion: In this study all of the cases and controls had anti Chlamydia antibodies. (IgG) high prevalence due to cold climate and high crowd of people in this area may be related to Chlamydia infection.

Background and Objectives: Cholera is an endemic disease in Iran and some cases of this disease are reported throughout the world annually. The aim of this study was to determine epidemiology and antimicrobial resistance patterns of Vibrio cholerae O1 biotype ELTor serotype Inaba in 2005 summer outbreak in Iran. Methods: Stool samples were collected from patients suspected of having cholera who were admitted to hospitals and clinics and then were cultured in TCBS.Specimens examined by confirmed bacteriological methods and ultimately they were serotyped by special antiserums. Finally 5% of the isolates were sent to Cholera Reference Laboratory for confirmation, serotyping and susceptibility testing. Antimicrobial susceptibility testing was performed by disk diffusion methods and E-test minimal inhibitory concentration (MIC) as recommended by NCCLS.Results: Totally. 1118 patients were to have cholera the epidemicity. The Disease was reported from twenty six provinces. The majority of cases were reported from Tehran. Qum and Hamedan with 219, 190 and 150 cases respectively. 50% of patients were between 15-34 years old. 53% of patients were male and 47% female. 97.7% of patients had Iranian nationality, 2.3% were from Afghanistan and Pakistan. 20% of patients were hospitalized and 80% were treated as outpatients.Case mortality rate was 1%. 1104 isolates were Inaba serotype and only 14 cases were ogawa serotype. Our studies revealed that the origin of Vibrio cholerae was consumption of raw vegetables that were watered by sewage. We also isolated V. cholerae from sewages. All isolates were resistant to Co-trimoxazole, Nalidixic acid, Furazolidone, and intermediate to Chloramphenicole. All isolates were susceptible to Tetracycline, Ciprofloxacin. and Erythromycin. MIC for Co-trimoxazole and Nalidixic acid were over 256mg/ml and 1.5mg/ml for Erythromycin. The antibiogram results showed that all isolates had the same origin.Conclusion: Our study reveals that, unlike previous epidemics, the causative agent of cholera in summer outbreak of 2005 was V. Cholerae ELTor, serotype Inaba. Concering the similar antibiogram pattern they had the same origin. 

Background and Objectives: Because of huge growth of snack food industry in the last few years the nation's eating habits are undergoing major transformation with a replacement of traditional main meals by more frequent snacking. Dietary changes have been notable in children and particularly students so they are the major consumers of these foods. The aim of this study was to evaluate the snack and sweet drinks consumption at school times and its relationship with first molar cavities level in a group of students.Methods: The study was carried out in a group of 400, 8-12 year-old boy students in Area 5 Tabriz School. Data were collected through simple examination and questionnaire completed by a interviewer. Findings were analyzed with descriptive statistic methods and chi-square Test.Results: The findings showed that nearly all the students (91%) had one or more snack or sweet drink at school time. Biscuits, dried berries and raisins and packed fruit juice were the most popular. First molar cavities as expressed in DMFT increased significantly with high intake of snacks.Conclusion' Snack and sweet drinks consumption is high among Tabriz students, and first molar cavities level is increased with high snacks intakes.

Background & Objectives: Ardabil city with population of about 340386 is still supplied with groundwater resource for drinking. That should have optimum quality standards in different aspects. If a drinking water physicochemical parameters levels is higher than the permitted recommended levels, they may create irreversible damages. This study intended to determine the physicoehemical parameters of drinking water in Ardabil in the year 2004.Methods: This is a descriptive cross-sectional study that has been done on 35 samples of Ardabil city drinking water resources in 2004. Most of the physicochemical parameters due to their importance and present limitations or even through technical restriction in water and wastewater laboratory of Ardabil health care centers were chemically analyzed and the results were statistically analyzed and compared by 1053 country standard methods.Results: According to the results of analyzed samples and their comparison with their related standard, it is estimated that So4, Po4 and total hardness of samples were %9, %71 & %41 respectively more than maximum acceptable level. Fluorine of samples was %57 less than the minimum recommended fluorine.Conclusion: Due to the lack of consistency in the values of So4, Po4, fluorine and total hardness of testing samples with the related standards, programming for obviation of the problems stems essential.

Background and Objectives: Hyper prolactinemia is a disorder which is presented in clinical forms of galatrrhea infertility, menstural disorder, hirsotism and PMS.Bromocriptin is agonist of dopamine and a drug for treatment of this disorder. Because of the necessity in continuous consumption of this drug (even for many years), the acceptance of the patients to the drug is important. In the present study the side-effects and acceptance level of patients to bromocriptin for the two forms of oral and vaginal use were studied.Methods: This study is a single-blinded clinical trial. Cases of study were patients referring Gynecology clinic with complaints of "Galactoria, Hirsotism, Menstural disorders and infertility." The samples were 180 (two groups of 90 members each) and the length of study was two years. The samples were divided into two groups, (oral & vaginal). Before the start of the study, cases underwent, in terms of systemic and local complication, systemic and gynceologic examination to control systemic and local side effects. After health assurance of other systems, drugs were administered in two forms one group oral and the other group vaginal. The data was collected on the basis of questimnaire and analyzed by SPSS.Results: This study showed the side effects of Bromcriptin in oral-forms they were 100% and for vaginal-from they were 43.2%. Most of the side effects in oral from were nausea 38.9% and in vaginal from was vaginal itching (22.3%). Vertigo in oral forms was more than vaginal form (27.8% to 2.3%). Hypotension was seen in 11.2% of oral forms but not in vaginal al form. About 51.2% of oral form group had more than two complications. In both groups the most complications were seem within the first ten days, 37.8% and 66.7%). Severity of side effects in 31.2% of oral forms and 11% of vaginal forms were so tense that resulted to patients discontinuation of the drug.Conclusion: There is a significant difference between severity, intensity and kind of complications in the forms of oral and vaginal use of Branocriptin and acceptance and duration of drug intake in vaginal forms is more than oral forms.

Background & Objectives: Spironolactone is a diuretic and antiandrogenic drug and is used in the trea ment of hypertention secondary hyprealdosteronism; congestive heart failure' cirrhosis of the liver, nephrotic syndrome 'androgenic alopecia' gynecomastia and hirsutism. In this research, the effects of spironolactone on the serum LH, FSH, testosterone, dihydrotestosterone, and changes in body weight and testicular tissue in adult male rats, were studied.Methods: For this purpose 190±10 g male wistar rats (n=40) were randomly divided into the following groups: control, sham operated (received water) and 25, 50, 100 mg/kg oral spironolactone treated groups. After 14 days body weight and testis weight under laboratory methods, were measured and blood samples were taken from heart and used for the measuring of LH/FSH/testosterone and dihydrotestosterone and then the rates' testes, in order to evaluate the histological changes, were removed and weighed and after obtaining tissue section and staining through HE, they were studied.Results: Serum LH level showed a significant increase and testos erone and dihydrotestosterone levels showed significant decrease in 100mg/kg spironolactone treated group (p£0.05) and there was no significant difference among serum FSH level, body weight and testicular weight as compared to control group.Conclusion: It can be concluded that oral administration of spironolactone maxima dose for 14 days could increase serum LHlevel and decrease testosterone and dihydrorestosterone levels.

Background & Objectives: Tension headache is one of the most common types of headaches that millions of people suffer from it. So far different treatments have been used to confront with tension headaches. According to the studies, tension headaches usually respond well to non-pharamacological treatment. The objective of this survey is the comparison between efficacy and effectiveness rate of SIT and medical treatment for tension headache treatment.Methods: In this study, 30 patients who had referred to neurology clinic of Alavi Hospital and private clinics, during the months of June and July in 2003, with chronic tension headache complaint, were selected randomly. These 30 patients were entered to two study groups and the third control groups. The patients in the first and second group received SIT and medical treatment respectively. The third group was considered as the control group and received no intervention. Indices of headache (frequency, severity and duration) were evaluated in 3 stages (Before treatment, after treatment and within one-month follow up period) by using a headache record device for all of patients. The collected data were analyzed by inferential statistical SIT methods, variance analysis and LSD pair comparison.Results: The data found from ANOVA methods (Analysis of variance) showed that both methods (Stress inoculation training and medical treatment) are effective in the treatment of chronic tension headache, but comparison between two groups showed that the group who received SIT had a significant difference compared to the group who received medical treatment in terms of efficacy rate on duration and consistency of headache symptom (p<0.05). In other indices of headache (frequency and severity), there was no significant difference between these two groups.Conclusion: This study showed that effectiveness rate of stress inoculation training is more effective than medical treatment of tension headache (in terms of headache symptoms duration and consistency).

Background and Objectives: Emoployees' job satisfaction (JS) is related to multiple factors and one of which is the personality factors. The present study was an attempt to find a relationship, if any, between personality and job satisfaction among Ardabil universities' staff.Methods: This descriptive study was conducted on 247 employees who were sampled from a population of 390 individuals working in Ardabil University of medical sciences, Mohaghegh Ardabil University and Islamic Azad University of Ardabil. Instruments used for data collection were Bren Rowiter personality test and standard job satisfaction test. The personality test evaluated neurosis, autism, introversion / extroversion, dominance, self confidence and socialization in the subjects.Results: The findings indicated that socialization and self confidence were the most common characteristics among the subjects. These employees enjoyed a moderate to high job satisfaction). Neurosis and dominance tendencies can predict the job satisfaction among the university staff. It was also shown that men had more dominance than women.Conclusion: Since there was a positive correlation between self confidence and neurosis with JS, in order to promote JS, it is recommended to hold JT classes aiming to teach methods of controlling anger and improving self-confidence. Besides, the authorities in these universities should be taught to create a sense of respect in the employees rather than criticizing and blaming them. This can enhance self-confidence and improve JS among these employees.

Background & Objectives: 11% of all newborns in the developing countries suffer from low birth weight (LBW). Birth weight has an important role in individual health, family and society. Lower and higher birth weight from standard rate lead to morbidity and mortality. The purpose of this study was to determine associations between some (If maternal anthropometric measurements such as BMI, pre-gravida weight, height, age with birth weight.Methods: 1his is an analytical-descriptive study, in which there were 300 pregnant women who hard referred to Alavi Hospital, Ardebil for delivery. Maternal pre-gravida height, weight and birth weight were collected from their units. Body mass index (BMI) was calculated by dividing the maternal pre-gravida weight in kg by height in m squared (kg/m2) the relationship between maternal anthropometric measurements and birth weight was analyzed by Hest.Results: Our study showed that 32 (10.7%) women had BMI<19.8, 185 (61.7%) BMI=19.8- 26 and 83 (27.7%) BMI>26 36.3% of women were under 55 kg, 48.3% between 55 to 70 kg and 15.3% over 70 kg. The relationship between maternal pre-gravida BMI, weight and birth weight was statistically significant (p=0.001). There was no significant difference between maternal age and neonatal birth weight.Conclusion: Pre-gravida body mass index (BMI) and weight could be two important anthropometric measurements associated with birth weight. Thus, it is recommended that women give adequate preconception and prenatal care to decrease the amount of LBW and HBW in population.

Background and Objectives: Pseudomonas aeruginosa is a nosocomial pathogen that presents high antibiotic resistance. There are phenotyping and genotyping methods for epidemiologic study of Pseudomonas aeruginosa such as antibiotic resistance pattern and plasmid profile analysis. Plasmid analysis provides useful information concerning the source of the strains and number of clones present in the epidemies. Thus, this study was conducted to evaluate antibiotic and plasmid profiles of P.aeruginosa strains isolated from in-patients of the Sina Medical Centre of Tabriz to clarify epidemyological correlation among isolated strains.Methods: Daring 13 months, 135 strains of P. aeruginosa were isolated from different infections in hospitalized patients at Sina Medical Center of Tabriz. Antibiotic susceptibility tests were performed Lsing disc agar diffusion test. For plasmid DNA extraction and detection of open circular bands from super coiled ones, modified alkaline lysis procedure and two dimensional electrophoresis were used, respectively. Enzymatic digestion of plasmids was carried out by EcoRI and HincII restriction enzymes.Results: Resistance rates of strains against antibacterial agents were recorded as: Aztreonam (77%), colistin (74%), ceftazidime (69%), pipracillin (67%), of loxacin (62%), tobramycin (56%), carbenicillin (54%), gentamicin (51%), ciprofloxacin (22%), amikacin (15%), polymixin B (13%) and imipenem (2%). Plasmid profiles of our test strains revealed that only 67 strains harbored plasmid (s). Number of isolated plasmids ranged 1-6 in each strain with molecular mass of 0.5kb- 21kb. When the isolated plasmids were digested using restriction endonuclease enzmes (EcoRI and HincII), in 32% of them similar digestion profiles were obtained by EcoRI indicating a unique source for them.Conclusion: Our findings suggest high antibiotic resistance and plasmid presence in P. aeruginosa strains isolated from different infections, and there were remarkable similarities among isolated plasmids. Since our test strains had been isolated from various wards in a short period of time, the results raise the possibility of unique source for some strains or high prevalence of genetic exchange among P. aeruginosa strains.